title: Willingness score obtained after a short CPAP trial predicts CPAP use at 1 year.
abstract: OBJECTIVE
  To predict continuous positive airway pressure (CPAP) adherence at 1 year.
  
  
  METHODS
  We followed consecutive OSA patients scheduled for CPAP initiation for 1 year. Patients completed a self-efficacy questionnaire (5 = low, 25 = high score) before CPAP initiation. After CPAP initiation, we enquired about patients' satisfaction in CPAP trial and their eagerness and willingness to continue CPAP therapy (0 = unsatisfied, uneager, or refused CPAP; 100 = satisfied, eager, or willing to continue CPAP treatment).
  
  
  RESULTS
  Of the 580 patients we followed, 377 continued CPAP therapy beyond 1 year. A low willingness score (<50) was expressed by 77 patients but only 7 of them used CPAP >4 h daily at 1 year, yielding a specificity of 97 % in predicting CPAP failure. At 1 year, patients with a self-efficacy score >20, expressed prior to CPAP initiation, used CPAP more often than the patients with a score <20 (average use 4.4 ± 2.2 h vs. 3.7 ± 2.3 h, p<0.001).
  
  
  CONCLUSIONS
  A low score of willingness to continue CPAP therapy after a short trial predicts CPAP failure and poor CPAP adherence at 1 year.
authors.affiliation: Sleep Unit, Division of Pulmonary Medicine, Department of Medicine, Helsinki University Central Hospital, Haartmaninkatu 4, PO Box 372, FIN-00029 HUS, Helsinki, Finland, hanna-riikka.kreivi@hus.fi.
authors.forename: Hanna-Riikka
authors.initials: HR
authors.lastname: Kreivi
authors.forename: Paula
authors.initials: P
authors.lastname: Maasilta
authors.forename: Adel
authors.initials: A
authors.lastname: Bachour
mesh_terms: D000328:Adult; D000368:Aged; D045422:Continuous Positive Airway Pressure / Q000523:psychology*; D005260:Female; D005387:Finland; D005500:Follow-Up Studies; D006801:Humans; D006813:Humidity; D008134:Long-Term Care / Q000523:psychology; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010349:Patient Compliance / Q000523:psychology*; D017060:Patient Satisfaction; D020377:Self Efficacy; D020181:Sleep Apnea, Obstructive / Q000523:psychology* / Q000628:therapy*; D011795:Surveys and Questionnaires